癫痫患者中医证素与长程脑电特点的关系研究  

Relationship of Traditional Chinese Medicine Syndrome Elements with Long-Term Electroencephalogram of Epilepsy Patients

作　　者：王楚杰 于征淼[1] WANG Chu-Jie;YU Zheng-Miao(The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2022年第1期12-18,共7页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】对癫痫患者进行证素调查和长程视频脑电图检查,描述其中医证素分布特点及脑电图特点,并进一步探讨证素与脑电图之间的联系。【方法】按前瞻性研究设计,纳入癫痫患者,采集一般资料,使用《癫痫中医证候调查表》进行证素调查,并进行长程视频脑电图检查,描述证素分布、证素组合分布、脑电图检查结果。运用统计学方法,对证素进行分析归类,分析证素特点与脑电图特点之间的关联。【结果】(1)证素和证素组合分布:本研究共纳入癫痫患者64例。证素出现率从高至低依次为风、闭、痰、脾气虚、瘀、火、肾阴虚、心血虚、肾阳虚证;兼具两个证素的证素组合的出现率最高为风-闭、风-痰、痰-闭。(2)脑电图检查结果:23.44%(15/64)患者的脑电图正常,18.75%(12/64)调节调幅好,57.81%(37/64)反应性好,53.13%(34/64)出现光驱动反应;17.19%(11/64)背景频率慢化,59.38%(38/64)有局部性慢波,26.56%(17/64)快波增多;3.13%(2/64)出现棘波,12.50%(8/64)尖波,39.06%(25/64)棘慢复合波或尖慢复合波,7.81%(5/64)多棘慢复合波;10.94%(7/64)记录到癫痫发作。(3)证素特点与脑电图特点的关系:通过聚类分析,可将证素分为3类:(1)瘀、火、肾阴虚、心血虚、肾阳虚;(2)风、闭;(3)痰、脾气虚。各证素的脑电图特点比较,差异均无统计学意义(P>0.05)。风证与调节调幅,瘀证与反应性、光驱动,心血虚证与顶尖波、棘波、尖波存在相关性(P<0.05)。【结论】风、闭、痰证是癫痫患者最常见的证素,三者的各种组合也是最常见的证素组合;某些证素之间关系更为密切,如风证与闭证,痰证与脾气虚证;证素可能与脑电图特点有一定的联系,风证的背景调节调幅较好,瘀证的脑电反应性较差、光驱动出现率较高,心血虚证的顶尖波、棘波、尖波的出现率均较高。Objective The characteristics of the syndrome elements and long-term video electroencephalogram(EEG)in epileptic patients were investigated for the exploration of the relationship of the syndrome elements with EEG in epilepsy patients. Methods According to the prospective study design, patients with epilepsy were included and their general data were collected. The syndrome elements were investigated by using the“Traditional Chinese Medicine Syndrome Questionnaire for Epilepsy”,and long-term video EEG examination was conducted.The distribution of syndrome elements, distribution of syndrome element combination, and EEG results were analyzed. Statistical methods were used for the analysis and classification of the syndromes,and the correlation between syndrome elements and EEG was analyzed. Results (1)Distribution of syndrome elements and syndrome element combination:a total of 64 epilepsy patients were included in this study. The occurrence rates of syndrome elements of wind,obstruction,phlegm,spleen qi deficiency,blood stasis,fire,kidney-yin deficiency,heartblood deficiency, and kidney-yang deficiency were in decreasing sequence. The two-syndrome element combinations of wind-obstruction,wind-phlegm and phlegm-obstruction had the the highest occurrence rates.(2)EEG examination results: 23.44%(15/64)of the patients had normal EEG, 18.75%(12/64)had good amplitude modulation in EEG, 57.81%(37/64)had good response in EEG, and 53.13%(34/64)had photic driving reaction. The incidence of slowed-down background frequency in EEG was 17.19%(11/64),local slow wave was 59.38%(38/64),and increased fast wave was 26.56%(17/64). The incidence of spike wave in EEG was3.13%(2/64),sharp wave was 12.50%(8/64),slow spike complex wave or slow sharp complex wave was 39.06%(25/64), and multispinous slow complex wave was 7.81%(5/64). Epileptic seizures had been recorded in10.94%(7/64)of the patients.(3)The relationship between the syndrome elements and EEG:syndrome elements can be classified into three categories through cluster analysi

关 键 词：癫痫 脑电图 证素 风证 闭证 痰证 

分 类 号：R277.7[医药卫生—中医学]